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ABSTRACT: The long list of ophthalmologic findings and symptoms at a baseline examination of a patient with uveitis can have an impact on further laboratory workup and differential diagnosis.
Based on publications and previous work, a decision tree was transformed into the expert system shell D3. A web-based Java Servlet was then programmed and published on our website (http://www.uveitiscenter.de at DiagnoseFinder). Ophthalmologic findings and symptoms of the patient can be checked with this online questionnaire, and recommendations for further laboratory tests and further care of the patient received.
Retrospective analysis of 62 patients with characteristic features of secondary uveitis showed a good correlation between the actual diagnosis of the patient and the diagnosis found by the program. In 74% of cases, the correct diagnosis was found among other options. In 37%, only the correct diagnosis was found, while in 37% the correct diagnosis was found among other probable diagnoses. Not all forms of secondary uveitis were found easily by the software.
This program is meant to be an easily accessible and simply employable help for the care of patients with a secondary form of uveitis. It is intended to be a support not only for residents in particular, but also for ophthalmologists in private practice who rarely treat patients with uveitis.
Der Ophthalmologe 06/2006; 103(5):406-9. · 0.62 Impact Factor
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ABSTRACT: Newborns are a vulnerable population: Exposed to dramatically changing environmental conditions, potentially suffering from impairments that cannot realistically be diagnosed during pregnancy, with the risk that unfavorable conditions escalate fast. We have investigated informatics methods and tools to make screening for congenital diseases and containment of critical processes that start in the first days safer and more efficient. This poster present a set of three different methodological approaches that all aim at comprehensive improvement of neonatal care.
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 02/2005;
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ABSTRACT: In order to implement clinical practice guidelines for the Department of Neonatology of the Heidelberg University Medical Center we developed a modular framework consisting of tools for authoring, browsing and executing encoded clinical practice guidelines (CPGs).
Based upon a comprehensive analysis of literature, we set up requirements for guideline representation systems. Additionally, we analyzed further aspects such as the critical appraisal and known bridges and barriers for implementing CPGs. Thereafter we went through an evolutionary spiral model to develop a comprehensive ontology. Within this model each cycle focuses on a certain topic of management and implementation of CPGs.
In order to bring the resulting ontology into practice we developed a framework consisting of a tool for authoring, a server for web-based browsing, and an engine for the execution of certain elements of CPGs. Based upon this framework we encoded and implemented several CPGs in varying medical domains.
This paper shall present a practical framework for both authors and implementers of CPGs. We have shown the fruitful combination of different knowledge representations such as narrative text and algorithm for implementing CPGs. Finally, we introduced a possible approach for the explicit adaptation of CPGs in order to provide institution-specific recommendations and to support sharing with other medical institutions.
Methods of Information in Medicine 02/2004; 43(4):413-26. · 1.53 Impact Factor
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ABSTRACT: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.
Methods of Information in Medicine 06/2001; 40(2):163-7. · 1.53 Impact Factor
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ABSTRACT: To assess the use of guidelines in neonatology we conducted a survey on hyperbilirubinemia in 185 German pediatric hospitals from June to September 1999. Of these 136 hospitals (73%) treating infants with hyperbilirubinemia responded. Specific standards or guidelines were used by 99% of participating hospitals. 49% of those used a hospital-based guideline, 54% the recommendations of the Gesellschaft für Neonatologie und pädiatrische Intensivmedizin, 24% another not further specified guideline. In 98% of the hospitals paper copies were used. In 21% of the hospitals the implemented guidelines were also electronically available. A coordinator for their guidelines was available in 51% of the hospitals, whereas 49% did not coordinate locally the use of their guidelines. In conclusion, guidelines should be well maintained and regularly updated in order that they do not lose their impact and significance. In addition, the potential of these concise summaries of medical expertise do not seem to be fully exploited.
Zeitschrift für ärztliche Fortbildung und Qualitätssicherung. 10/2000; 94(8):683-8.
